Allograft transplantation in aggressive or malignant bone tumors

Twenty-three patients with aggressive benign or malignant bone tumors had segmental allograft replacements after resection of the tumors. The mean age of the patients was 30 years of age. The mean length of the allografts was 14 cm. The allografts consisted of intercalary allograft (5), allograft arthrodesis (12), and allograft-prosthetic composite (6). Intramedullary fixation with or without additional compression plate was used to osteosynthesize all the osteotomy sites with the exception of one in which a long nail plate was used. A supplement of autogeneic bone grafts at the allograft-host junction was performed in 18 patients. Seven patients received preoperative and postoperative chemotherapy for high grade sarcomas. At an average follow-up period of four years, 78% of the patients had excellent or good results. The union rate of the grafts was 86%. Supplement with autografts shortened the union time of the allograft from 15 to eight months. One patient had a tumor recurrence and one died of the disease. Other complications included one delayed union, two nonunions of the allograft, two late infections, and one neuropathy. Allograft transplantation is an acceptable method for tumor reconstruction. The adjuvant chemotherapy did not have significant adverse effects on its outcome. Complications that relate to allografting are common, but most of them are salvageable.